The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK
Background The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with reg...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2021-06, Vol.47 (3), p.637-645 |
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| container_title | European journal of trauma and emergency surgery (Munich : 2007) |
| container_volume | 47 |
| creator | Adiamah, Alfred Thompson, Amari Lewis-Lloyd, Christopher Dickson, Edward Blackburn, Lauren Moody, Nick Gida, Sunil La Valle, Angelo Reilly, John-Joe Saunders, John Brooks, Adam |
| description | Background
The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.
Methods
This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020–18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019–20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher’s exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality.
Results
A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (
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| doi_str_mv | 10.1007/s00068-020-01593-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7871318</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2538895493</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-ebcb7409904db2e2cc995b769d5a640e1e13203d45a422c7209c196baa38131d3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0Eou3AH2CBLLHpJnD9im0WSGhKYUTFLJiyQ5bjeNpMk3iwE0b995hJmRYWrPy43zm-1wehFwReEwD5JgFAqQqgUAARmhW7R-iYqJIVWnPy-LBn7AidpLTJNJSCPkVHjAmhSy2P0ffVtceL-fILXkU7dhZ_Hcb69i0e8nXTba0bcFjvT_Plt8VZQTRug7upw67Hoced3YSIh0m6C_GmDbbGTb9XXH5-hp6sbZv887t1hi7PP6zmn4qL5cfF_P1F4bjkQ-ErV0kOWgOvK-qpc1qLSpa6Frbk4IknjAKrubCcUicpaEd0WVnLFGGkZjP0bvLdjlXna-f73FJrtrHpbLw1wTbm70rfXJur8NNIJbOBygandwYx_Bh9GkzXJOfb1vY-jMlQrqTkihHI6Kt_0E0YY5_HM1QwpbTg-cdniE6UiyGl6NeHZgiY3-mZKT2T0zP79Mwui14-HOMg-RNXBtgEpFzqr3y8f_s_tr8AbLKj8w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2538895493</pqid></control><display><type>article</type><title>The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK</title><source>SpringerLink Journals - AutoHoldings</source><creator>Adiamah, Alfred ; Thompson, Amari ; Lewis-Lloyd, Christopher ; Dickson, Edward ; Blackburn, Lauren ; Moody, Nick ; Gida, Sunil ; La Valle, Angelo ; Reilly, John-Joe ; Saunders, John ; Brooks, Adam</creator><creatorcontrib>Adiamah, Alfred ; Thompson, Amari ; Lewis-Lloyd, Christopher ; Dickson, Edward ; Blackburn, Lauren ; Moody, Nick ; Gida, Sunil ; La Valle, Angelo ; Reilly, John-Joe ; Saunders, John ; Brooks, Adam ; ICON Trauma Study Group ; The ICON Trauma Study Group</creatorcontrib><description>Background
The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.
Methods
This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020–18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019–20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher’s exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality.
Results
A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (
p
< 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables.
Conclusion
Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-020-01593-w</identifier><identifier>PMID: 33559697</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Coronaviruses ; COVID-19 ; Critical Care Medicine ; Emergency medical care ; Emergency Medicine ; Intensive ; Medicine ; Medicine & Public Health ; Mortality ; Original ; Original Article ; Pandemics ; Severe acute respiratory syndrome coronavirus 2 ; Shelter in place ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Trauma ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2021-06, Vol.47 (3), p.637-645</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-ebcb7409904db2e2cc995b769d5a640e1e13203d45a422c7209c196baa38131d3</citedby><cites>FETCH-LOGICAL-c474t-ebcb7409904db2e2cc995b769d5a640e1e13203d45a422c7209c196baa38131d3</cites><orcidid>0000-0002-0624-6197</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-020-01593-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-020-01593-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33559697$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adiamah, Alfred</creatorcontrib><creatorcontrib>Thompson, Amari</creatorcontrib><creatorcontrib>Lewis-Lloyd, Christopher</creatorcontrib><creatorcontrib>Dickson, Edward</creatorcontrib><creatorcontrib>Blackburn, Lauren</creatorcontrib><creatorcontrib>Moody, Nick</creatorcontrib><creatorcontrib>Gida, Sunil</creatorcontrib><creatorcontrib>La Valle, Angelo</creatorcontrib><creatorcontrib>Reilly, John-Joe</creatorcontrib><creatorcontrib>Saunders, John</creatorcontrib><creatorcontrib>Brooks, Adam</creatorcontrib><creatorcontrib>ICON Trauma Study Group</creatorcontrib><creatorcontrib>The ICON Trauma Study Group</creatorcontrib><title>The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Background
The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.
Methods
This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020–18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019–20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher’s exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality.
Results
A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (
p
< 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables.
Conclusion
Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.</description><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Critical Care Medicine</subject><subject>Emergency medical care</subject><subject>Emergency Medicine</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original</subject><subject>Original Article</subject><subject>Pandemics</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Shelter in place</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Trauma</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUtv1DAUhS0Eou3AH2CBLLHpJnD9im0WSGhKYUTFLJiyQ5bjeNpMk3iwE0b995hJmRYWrPy43zm-1wehFwReEwD5JgFAqQqgUAARmhW7R-iYqJIVWnPy-LBn7AidpLTJNJSCPkVHjAmhSy2P0ffVtceL-fILXkU7dhZ_Hcb69i0e8nXTba0bcFjvT_Plt8VZQTRug7upw67Hoced3YSIh0m6C_GmDbbGTb9XXH5-hp6sbZv887t1hi7PP6zmn4qL5cfF_P1F4bjkQ-ErV0kOWgOvK-qpc1qLSpa6Frbk4IknjAKrubCcUicpaEd0WVnLFGGkZjP0bvLdjlXna-f73FJrtrHpbLw1wTbm70rfXJur8NNIJbOBygandwYx_Bh9GkzXJOfb1vY-jMlQrqTkihHI6Kt_0E0YY5_HM1QwpbTg-cdniE6UiyGl6NeHZgiY3-mZKT2T0zP79Mwui14-HOMg-RNXBtgEpFzqr3y8f_s_tr8AbLKj8w</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Adiamah, Alfred</creator><creator>Thompson, Amari</creator><creator>Lewis-Lloyd, Christopher</creator><creator>Dickson, Edward</creator><creator>Blackburn, Lauren</creator><creator>Moody, Nick</creator><creator>Gida, Sunil</creator><creator>La Valle, Angelo</creator><creator>Reilly, John-Joe</creator><creator>Saunders, John</creator><creator>Brooks, Adam</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0624-6197</orcidid></search><sort><creationdate>20210601</creationdate><title>The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK</title><author>Adiamah, Alfred ; Thompson, Amari ; Lewis-Lloyd, Christopher ; Dickson, Edward ; Blackburn, Lauren ; Moody, Nick ; Gida, Sunil ; La Valle, Angelo ; Reilly, John-Joe ; Saunders, John ; Brooks, Adam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-ebcb7409904db2e2cc995b769d5a640e1e13203d45a422c7209c196baa38131d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Critical Care Medicine</topic><topic>Emergency medical care</topic><topic>Emergency Medicine</topic><topic>Intensive</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original</topic><topic>Original Article</topic><topic>Pandemics</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Shelter in place</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Trauma</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adiamah, Alfred</creatorcontrib><creatorcontrib>Thompson, Amari</creatorcontrib><creatorcontrib>Lewis-Lloyd, Christopher</creatorcontrib><creatorcontrib>Dickson, Edward</creatorcontrib><creatorcontrib>Blackburn, Lauren</creatorcontrib><creatorcontrib>Moody, Nick</creatorcontrib><creatorcontrib>Gida, Sunil</creatorcontrib><creatorcontrib>La Valle, Angelo</creatorcontrib><creatorcontrib>Reilly, John-Joe</creatorcontrib><creatorcontrib>Saunders, John</creatorcontrib><creatorcontrib>Brooks, Adam</creatorcontrib><creatorcontrib>ICON Trauma Study Group</creatorcontrib><creatorcontrib>The ICON Trauma Study Group</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adiamah, Alfred</au><au>Thompson, Amari</au><au>Lewis-Lloyd, Christopher</au><au>Dickson, Edward</au><au>Blackburn, Lauren</au><au>Moody, Nick</au><au>Gida, Sunil</au><au>La Valle, Angelo</au><au>Reilly, John-Joe</au><au>Saunders, John</au><au>Brooks, Adam</au><aucorp>ICON Trauma Study Group</aucorp><aucorp>The ICON Trauma Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>47</volume><issue>3</issue><spage>637</spage><epage>645</epage><pages>637-645</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Background
The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.
Methods
This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020–18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019–20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher’s exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality.
Results
A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (
p
< 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables.
Conclusion
Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33559697</pmid><doi>10.1007/s00068-020-01593-w</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0624-6197</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1863-9933 |
| ispartof | European journal of trauma and emergency surgery (Munich : 2007), 2021-06, Vol.47 (3), p.637-645 |
| issn | 1863-9933 1863-9941 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7871318 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Coronaviruses COVID-19 Critical Care Medicine Emergency medical care Emergency Medicine Intensive Medicine Medicine & Public Health Mortality Original Original Article Pandemics Severe acute respiratory syndrome coronavirus 2 Shelter in place Sports Medicine Surgery Surgical Orthopedics Trauma Traumatic Surgery |
| title | The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK |
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